2017 – 2018 Annual Report

• Enhance the quality of health professions education using the best academic resources available statewide
• Retain Arkansas graduates of health professions schools within the state
• Improve the supply and distribution of primary healthcare providers in Arkansas
• Increase the number of individuals from rural, minority, and underserved populations entering health careers
• Supply professional support and continuing education for healthcare providers statewide
• Provide quality health care services and educational programs to the public
• Promote cooperation among providers, educational institutions, and health-related organizations

Pre-Health Professions Recruiters continue to travel their regions to encourage students across the state to become Arkansas’ health professionals of tomorrow, this year reaching 26,525 students statewide.

Medical Applications of Science for Health (M*A*S*H)

In Summer 2017, 434 high school students participated in one of 32 M*A*S*H camps across the state, with 72% from rural or minority backgrounds. During this two-week program for students entering grades 11 and 12, participants are certified in First Aid and CPR, learn healthy lifestyles, and apply science concepts to “real life” healthcare situations. Ten medical students and three pharmacy students served as M*A*S*H program assistants.

Community Health Applied in Medical Public Service (CHAMPS)

In Summer 2017 and Spring 2018, 185 students participated in CHAMPS. This 3-5 day program offers hands-on experiences in health careers and community service for students entering grades 8, 9 and 10, with 58% from rural or minority backgrounds.

Advancement Into Medicine (AIM)

During 2017-18, 121 high school students participated in AIM, which continues to engage former M*A*S*H students through college advising, mentoring, interviewing and writing skills, clubs and community service.

Hands-On Health Care and Health Explorers

In 2017-18, 55 students glimpsed health careers through Hands-On Health Care activities such as giving injections, drawing blood, and physical therapy, as well as 1,391 Health Explorers engaged in other age-appropriate offerings.

A Day in the Life

These one-day events give an in-depth look into a specific health career, such as nursing or radiology, and include both lecture and hands-on activities. In 2017-18, 232 students participated.

Club Scrub & Med Pro-Ed

School-based clubs encourage exploration of health careers through meetings and activities, with 170 participants this year.

Medical Interpreting

Our UAMS Northwest recruiter, who is Hispanic, taught a Medical Interpreting class for 22 bilingual high school seniors this spring.

College Pre-Professional Training and Support

College students can arrange mentoring and volunteer service opportunities through any of our regional centers. Pre-Med students receive help applying for medical school through advising, mock interviews, and MCAT prep. This year 185 college students participated.

Group Presentations and Events

In addition to the structured programs described above, our recruiters reached 23,680 other students across the state through school presentations, career fair booths, facility tours, and other groups and venues to increase awareness about health careers, workforce needs, salary potential, training opportunities, and academic pre-requisites. Statewide, general networking also reached 2,101 parents and faculty.

The sports medicine fellowship for family physicians at the UAMS Northwest Campus offers advanced training on diagnosis and treatment of sports-related illness and injury, with cooperation from the University of Arkansas Athletics Department and other clinical partners. Sports medicine fellows gain clinical experience seeing patients at UAMS- affiliated clinics as well as working with University of Arkansas student-athletes, while under supervision of UAMS faculty and clinical partners, including Advanced Orthopedic Specialists, the official sports medicine provider for the Arkansas Razorbacks. Completing the fellowship will enable a physician to sit for the sports medicine subspecialty board exam by the American Board of Family Medicine.

Arkansas Blue Cross & Blue Shield Primary Care Scholarship

Three UAMS medical students were each awarded a $20,000 Arkansas Blue Cross and Blue Shield Primary Care Scholarship, which encourages aspiring physicians to pursue primary care practices in rural Arkansas.

This year’s recipients are Steven James, a senior from Conway; Julie Sherrill, a senior from Dumas; and Allison Jackson, a junior from Bryant.

The scholarship is a part of a broad effort to produce more family medicine, general internal medicine, and general pediatrics doctors for Arkansas, especially in rural areas where access to primary care is limited. The Arkansas Blue Cross and Blue Shield Primary Care Scholarship encourages aspiring physicians to pursue primary care in rural Arkansas.

Family Medicine Interest Group

This year, the Family Medicine Interest Group (FMIG) reached 415 students, with attendance at monthly meetings averaging 30-40. Guest speakers offer diverse perspectives to increase student awareness of all aspects of medicine, practice models, financial management, health care policies, and personal stories. Twenty-one medical students attended the 2017 AAFP National Student and Resident Conference July 27-30, in Kansas City, KS.

I can’t wait to practice the full scope of family medicine in a rural area that I love while developing relationships with the people that make rural Arkansas special.

Stephan James

Rural Medicine Student Leadership Association

The Rural Medicine Student Leadership Association (RMSLA) is sponsored by Regional Programs and Arkansas Farm Bureau to provide peer support for Rural Practice students, to inform state policy, to create connections between students and communities, and to provide regular meetings and speakers to discuss issues of importance to future rural physicians. This year, 175 students were involved in RMSLA.

Other Rural Practice Incentive Programs

Medical students who participate in the UAMS Rural Practice Program are required to complete a Family Medicine Preceptorship and their Junior Family Medicine Clerkship in a non-urban community, which often is one of our regional centers. Students must also complete a senior rotation (Primary Care Selective or Acting Internship) at a regional site.

In 2017-18, 39 medical students and 28 residents had a Rural Practice commitment, with another 29 physicians actually practicing in a qualifying community. Learn more about the Rural Practice Programs

Regional Programs offer students opportunities for hands-on training and classroom instruction from faculty and preceptors at our regional clinical locations in various parts of the state.

Since 2015, the UAMS Office of Interprofessional Education (OIPE) has introduced specific activities into each year of UAMS student curricula, with all students now required to

complete IPE activities in order to graduate. We work closely with OIPE co-directors, Wendy Ward, Ed.D. and Kat Neill, Pharm.D. to provide training and support to our multi-disciplinary center faculty and staff, to help them maximize functionality as fully integrated teams, both in clinical and educational capacities.

Pharmacy

This year, 39 pharmacy students completed training at one of our centers. UAMS Regional Programs clinical pharmacists enjoy an integral role in the complex care committees in their respective family medicine clinics, and to their centers’ scholarly activities and academic leadership initiatives. Intensive review of high utilization patients often reveals drug therapy opportunities to improve quality metrics and reduce costs. A particular point of emphasis has been review and quality improvement with prescription of opoids and other controlled substances, with these efforts paying dividends in improving consistency in proper provision and documentation of this type of care.

Nursing

In 2017-18, 79 nursing students from various educational institutions, ranging from nursing assistants to masters level practitioners, participated in educational courses and practicum experiences at our regional centers.

UAMS College of Nursing faculty at our regional centers teach courses and serve as faculty preceptors, while also assisting rural students with academic advising, registration, online and interactive video offerings, medical library access, and clinical preceptor assignments.

2017-2018 Nursing Students

Health Professions

Physician Assistants

There were 31 students from the UAMS Physician Assistant program who participated in clinical rotations at our regional centers this year. These experiences focused on clinical aspects of family medicine and primary care in both outpatient and inpatient settings.

Other Trainees

Other students included 3 Social Work Interns, (1 BSW, 2 MSW) at UAMS Northwest, Fayetteville; 2 Physical Medicine and Rehab students at UAMS South, Magnolia, and 1Medical Assistant student at UAMS West, Fort Smith.

Regional Programs continues to demonstrate exceptional financial performance in the management of its resources. The following information highlights key accomplishments for the period ended June 30, 2018:

• Regional Programs achieved an operating margin of 3.3% for FY 2018.

• This year, we were thrilled to open new Family Medical Clinics at UAMS East and UAMS North Central.
• We continue to improve upon the Patient Centered Medical Home (PCMH) model at all our Family Medicine Clinics with advance care processes and protocols as required under the PCMH delivery model.
• A key strategic initiative in FY 2018 was implementation of a statewide Electronic Health Record (EHR) system for Regional Programs. This singular initiative is the cornerstone for building the infrastructure that will enable Regional Programs to support the training of healthcare professionals in accordance with the new payment model of population health consistent with improved patient outcomes.
• Our management and staff continue to seek ways to reduce overall cost of operations by standardizing certain business processes, procuring of supplies and services under group purchasing agreements, and by ensuring that our human capital resources are optimally employed to meet program requirements.

Funding Sources 2017 – 2018

• Professional Fees: 53%
• State Funds: 24%
• Contracts: 17%
• Grants/Other: 3%
• Tobacco Funds: 3%

Expenditures 2017 – 2018

• Residency Programs: 38%
• Clinical Services: 33%
• Administration: 25%
• Public Education and Outreach: 3%
• Student Education: 2%
• Library and Continuing Education: 0.4%

As with every department and function within UAMS, this past year has presented its own unique challenges. We’ve learned the importance, now more than ever, of working together as a team to achieve our common goal of providing the best healthcare possible to our patients. The connections that are developed between our staff members and patients, and the team spirit that continues to evolve in our daily work are what makes our program succeed.

This year, we were very happy to welcome Dr. Mimo Lemdja as a new full time faculty member. Dr. Lemdja’s passion for service and her experience in patient care have made her a great asset to our program. We continue to be extremely fortunate to have Dr. Peter Carroll with us, sharing his more than 30 years of experience as a UAMS healthcare provider. In the past, Dr. Carroll served as residency program director and also as center director for UAMS South. Our staff and residents all agree that Dr. Carroll is a true gem. We much appreciate his dedication to our program.

We are entering our sixth year as a rural training track in Magnolia. As our residency program continues to evolve, we are thankful for the guidance of Dr. Mark Jansen as interim program director. We are committed to the continuous improvement of our resident education program as we remain focused on providing a training program that produces caring and competent, board- certified physicians who are prepared to serve rural populations. While change is sometimes hard, it can also bring unexpected benefits. Our community partners continue their support of our program, and we anticipate strengthening these relationships in the future.

Our clinic’s Women’s Health Nurse Practitioner, Adriane Delaney, was featured in our local newspaper for her contributions to the health of women in our community. Adriane, a self-described “home town girl”, is one of only a couple board certified women’s health nurse practitioners in South Arkansas. Adriane’s patient volume continues to grow, and she enriches our clinic’s ability to provide a full spectrum of healthcare services.

Once again, our local Albemarle Foundation has generously supported our Reach Out and Read program. Through a grant provided by this foundation, around 400 children in our community will receive brand new, age appropriate books during regularly scheduled visits with their healthcare providers. Many of the families served are low-income, and the books provided through this Reach Out and Read program are usually the first (and often the only) books these children own.

Our commitment to patient care was evident this year, as we successfully passed all quality measures and metrics from various state and federal programs, such as Arkansas Medicaid, Arkansas Blue Cross and Blue Shield, and Meaningful Use. UAMS South is proud to be a Patient Centered Medical Home where we continue to provide access to many services such as care coordination, radiology, telemedicine, and scheduling of preventive services.

The diversity of our talented team of local professionals makes us unique within our community. Our ability to provide quality care to our patients, without the need to travel far from home, is one of our greatest strengths. In a year that has been full of unexpected hurdles, I am very proud of our UAMS South team for navigating these many changes with substantial grace, professionalism, and teamwork.

Judy McDonald, Interim Administrative Director

UAMS Southwest, a major medical provider for the 4-State region saw new patient visits continue to grow in the Family Medicine Center. The All For Kids clinic is beginning to flourish. Both clinics made it through the new Centricity EMR implementation and now the challenge is to meet the population management quality goals for CPC+.

Our Family Medicine residency faculty remains experienced and stable, with 4.7 FTE. Dr. Mayo will be first to present a faculty development topic in January to the Regional Programs network as part of a new Graduate Medical Education Committee series.

All 8 graduating residents passed their board exam for the fourth year in a row, and the fifth out of the last six years. A beefed up didactic Thursday afternoon series has been instrumental in this trend. This year the 18th annual Sports Medicine Seminar and first Hospice & Palliative Medicine Seminar were series highlights.

Drs. Downs, Diaz, Nix, and Verma, with their respective teams of 2nd year residents, prepared poster presentations for the Regional Programs Scholarly Activity Colloquium in May. Dr. Downs was published TWICE in the Best Evidenced-Based Medicine journal this year. He and two recent graduates were in February’s issue, and he teamed up with 3rd year residents Dr. O’Kelley and Dr. Omakpokpose in March’s issue.

After not fully matching through the National Resident Match Program in 2017, feedback was elicited from applicants who matched to other programs. Residency Coordinator Elizabeth Flippo and Dr. Russell Mayo overhauled the recruiting process. This year the program not only matched, but matched all 8 of their spots within the first 20 ranked candidates making it one of the most successful matches for the program in its history.

The UAMS Southwest Family Medicine Residency will be the first within Regional Programs to undergo a Self Study process of the Next Accreditation System (NAS). A SWOT analysis with an Action Plan was submitted to the ACGME via WEB ADS last November. Accomplishments and progress toward the goals of the Action Plan will be submitted this November with an ACGME site visit planned for May 2019.

Telemedicine services benefit patients unable to travel to Little Rock for specialty care. Fifty patients received high-risk OB care through UAMS Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS) program.

We perform non-stress tests and patients receive visits from obstetrical specialists through telemedicine. Forty patients completed telemedicine visits with Arkansas Children’s Urology Clinic in the past year, including initial consults, follow-up visits, and post-op visits. Finally, 40 patients were treated in our newest telemedicine program with Arkansas Children’s Asthma Clinic. Patients meet with a Respiratory Therapist (RT) for spirometry, and then with a pediatric pulmonologist. The RT is available for asthma teaching and to develop an asthma action plan. We completed the first year of CPC+ as a Track 2 clinic and successfully submitted Electronic clinical quality measures (eCQMs). In the first year of AR Medicaid PCMH, we completed two care plans on 82% of our high priority beneficiaries. We launched an extensive library of community resources linked to our website and began social needs screening to identify and assist patients. We have begun an After-Hours Clinic on Monday evenings with same day availability to improve access for our patients.